Individual
MRS. JAIME ALLISON TICKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
2951 TANGERINE TER, PALM HARBOR, FL 34684-4040
(727) 224-3800
(727) 734-3192
Mailing address
2041 SCOTLAND DR, CLEARWATER, FL 33763-1338
(727) 734-3192
(727) 734-3192
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
765652100
—
FL
Enumeration date
03/23/2007
Last updated
02/27/2019
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